Nursing Elites

1. What finding would lead healthcare providers to suspect Turner syndrome in a child?

• A. Webbed neck
• B. Microcephaly
• C. Gynecomastia
• D. Cognitive delay

Correct answer: A

Rationale: A webbed neck is a classic physical characteristic seen in individuals with Turner syndrome, a genetic condition that results from a missing or partially missing X chromosome in females. This distinctive feature occurs due to excess skin on the neck and is a key clinical clue for healthcare providers. Microcephaly (choice B) refers to a small head size and is not typically associated with Turner syndrome. Gynecomastia (choice C) is the enlargement of breast tissue in males and is not a common finding in Turner syndrome. Cognitive delay (choice D) involves intellectual or developmental delays and is not a specific feature of Turner syndrome.

2. A parent and 3-month-old infant are visiting the well-baby clinic for a routine examination. What should the nurse include in the accident prevention teaching plan?

• A. Remove small objects from the floor.
• B. Cover electric outlets with safety plugs.
• C. Remove toxic substances from low areas.
• D. Test the temperature of water before bathing.

Correct answer: D

Rationale: Testing the temperature of water before bathing is crucial to prevent burns, which is a significant risk for infants due to their sensitive skin. Infants have delicate skin that can easily be burned by water that is too hot. Testing the water temperature before bathing ensures that the water is at a safe and comfortable level for the infant. While choices A, B, and C are also important in accident prevention, such as reducing choking hazards, preventing electric shocks, and avoiding poisoning, testing the water temperature before bathing is the most immediate and direct action to prevent harm to the infant during bathing.

3. What is important to include in discharge instructions for parents of a child who has had a tonsillectomy?

• A. Encourage the child to gargle with salt water
• B. Encourage fluid intake
• C. Provide the child with hard candy
• D. Apply heat to the neck

Correct answer: B

Rationale: Encouraging fluid intake is essential in the discharge instructions for a child who has had a tonsillectomy. It helps keep the throat moist, aids in preventing dehydration, and promotes healing. Gargling with salt water is not typically recommended after a tonsillectomy as it may irritate the surgical site. Providing the child with hard candy is not advisable as it can irritate the throat and potentially cause harm. Applying heat to the neck is also not recommended post-tonsillectomy as it can increase swelling and discomfort in the surgical area.

4. A child with a diagnosis of appendicitis is scheduled for surgery. What preoperative intervention is important for the nurse to perform?

• A. Administering antibiotics
• B. Maintaining strict NPO status
• C. Encouraging fluid intake
• D. Monitoring for signs of infection

Correct answer: B

Rationale: The correct preoperative intervention for a child with appendicitis scheduled for surgery is maintaining strict NPO (nothing by mouth) status. This is crucial to reduce the risk of aspiration during anesthesia induction and prevent potential complications during surgery. Administering antibiotics may be a part of the treatment plan but is not a preoperative intervention. Encouraging fluid intake is contraindicated preoperatively to avoid delays in surgery and complications related to anesthesia. Monitoring for signs of infection is important postoperatively to assess for any complications that may arise due to the surgical procedure.

5. Parents of a sick infant talk with a nurse about their baby. One parent says, “I am so upset; I didn’t realize our baby was ill.” What major indication of illness in an infant should the nurse explain to the parent?

• A. Grunting respirations
• B. Excessive perspiration
• C. Longer periods of sleep
• D. Crying immediately after feedings

Correct answer: C

Rationale: The correct answer is C. Longer periods of sleep than usual can be a sign of illness in infants. When an infant sleeps more than usual, it can indicate that the baby is conserving energy due to an underlying condition. Grunting respirations (choice A) can be a sign of respiratory distress, not just an indication of illness. Excessive perspiration (choice B) can occur due to various reasons and is not a specific major indication of illness. Crying immediately after feedings (choice D) is a common behavior in infants and not necessarily a major indication of illness.

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